Introduction

Question 1

What are the functions of the kidney

Answer 1

Regulate water, electrolytes, arterial blood pressure (via blood vol. and renin-angiotensin).
Excrete metabolic waste, foreign substances.
Acid base reg.
Reg. RBC production.
Vit D production.
Gluconeogenesis during long fasting.

Question 2

lumen of nephron

Answer 2

inside of the tube

Question 3

luminal side of tubular cell

Answer 3

side facing lumen of the cell surrounding the tube

Question 4

apical side of tubular cell

Answer 4

side facing apex of the cell surrounding the tube

Question 5

basolateral side of tubular cells

Answer 5

sides of tubular cells facing intersitial fluid

Question 6

what happens in the proximal convoluted tubule

Answer 6

67% of H2O, Na< K, Cl and nearly all glucose and AA reabsored here

Question 7

what is thick ascending limb sometimes called

Answer 7

diluting segement

Question 8

what happens in macular densa

Answer 8

Feedback to juxtaglomerular apparatus. Vasodilates/constricts afferent art. to maintain constant GFR and renal blood flow despite changes in systemic art. BP.

Question 9

what happens in the distal convoluted tubule

Answer 9

Reaborbs Na/K/Cl but impermeable to H20 and urea = also diluting segment.

Question 10

what happens in cortical collectin duct

Answer 10

Principal cell, reabsorbs Na and secretes K. Intercalating cell reabsorbs K and secretes H. Whole segment responsive to ADH.

Question 11

how is protein reabsorbed in the proximal tubule

Answer 11

Peptidases in lumen of proximal conv. Tubule (apical surface) break peptides into AAs which are
reabsorbed. Larger proteins endocytosed, lysosomic enzymes degrade to AAs which leave tubular cell
across basolateral memb. Normally all protein reabsorbed, but the mechanism for reabsorption can
become saturated and then proteinuria.

Question 12

Where does ADH act in the kidney

Answer 12

collecting duct

Question 13

what happens when you increase ADH

Answer 13

reabsorb more water, conc urine

Question 14

which nerve has parasympathetic innervation

Answer 14

S2, 3, 4 (pelvic nerves)

Question 15

what do SS2,3,4 do

Answer 15

contract bladder

Question 16

what neveres have symphatic innervation

Answer 16

L1,2,3 (hypogastric n)

Question 17

what nerves have coluntary moto input

Answer 17

S2,3,4 pudendal n

Question 18

vesicoureteral reflux

Answer 18

Backward flow of urine into ureters during bladder contraction. Enlarges ureters. Increases chances of kidney infection.

Question 19

ureterorenal reflex

Answer 19

Stone blocks ureter, sensory afferents from ureter cause reflex and constriction of renal arterioles. This decreases fluid flow from that kidney.

Question 20

micturition reflex

Answer 20

Initiated by bladder stretch receptors. Pelvic nerves carry sensory to sacral segments of cord, parasymps back tell detrusor to tighten and pressure spikes. As bladder fills, reflex gets stronger and occurs at faster rate. Is autonomic spinal cord reflex, can be inhibited/facilitated by the brain. Cortical and suprapontine centers in brain can inhibit this reflex.

Question 21

sympathetic storage reflex

Answer 21

initiated as bladder distends and afferent activity travels in pelvic nerves to spinal cord. Firing from symp L1,2,3 initiated – decrease parasymp inputs to bladder.

Question 22

somatic storage reflex (guarding or continence reflex)

Answer 22

caused by sudden increase in bladder pressure. Pelvic N to sacral spinal cord -> efferent somatic neurons in nucleus of Onuf are activated. Motor neurons to ext. sphincter. Inhibited during micturition so external sphincter will relax.

Question 23

atonic bladder

Answer 23

no micturition reflex

bladder does not empty and therefore leaks, causes overflow incontinence

Question 24

what can cause atonic bladder

Answer 24

crush injury to sacral region of spinal cord, tertiary syphilis

Question 25

what is automatic bladder

Answer 25

typical micturition can occur, but brain isn’t in control of the reflex for reflex empty eventually becomes automatic. overfill incontinence

Question 26

what can causes automatic bladder

Answer 26

spinal cord damage above sacral region

Question 27

what is the immediate effect on the bladder of spinal cord damage above sacral region

Answer 27

overflow incontinence

Question 28

what can cause uninhibited neurogenic bladder

Answer 28

partial damage to spinal cord or brainstem

Question 29

what is the syptoms of uninhibited neurogenic bladder

Answer 29

uncontrollable mictrutiion, even a small amount of urine in bladder causes you to pee